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Methylphenidate ER is a medication that requires careful consideration before use due to its associated risks and precautions. Below is important safety information that must be reviewed with your healthcare provider.

• Misuse and Dependence: This medication has the potential for misuse and dependence, particularly in individuals with a history of substance or alcohol use disorders. Misuse can lead to severe side effects like rapid heartbeat, high blood pressure, and aggressive behavior. It is crucial to follow your prescribed dosage and consult your healthcare provider before making any changes.

• Serious Heart Issues: There have been reports of sudden death, stroke, and heart attack in individuals taking methylphenidate ER at typical doses. This medication may increase blood pressure and heart rate. Inform your healthcare provider of any heart-related history before starting this medication, and seek medical advice if you experience symptoms like unexplained fainting, chest pain during physical activity, or an irregular heartbeat.

• Behavioral and Mood Changes: Use of methylphenidate ER can lead to mental health issues such as hallucinations, unclear thinking, and mania. It can exacerbate existing mood disorders or cause new behavioral symptoms even in those without prior issues. Contact your healthcare provider immediately if you notice any changes.

• Prolonged and Painful Erection: Rare but serious, prolonged and painful erections have been reported, potentially requiring surgical intervention. Should this occur, discontinue use and seek immediate medical attention.

• Blood Circulation Problems (Raynaud's Phenomenon): This medication may cause circulation issues, leading to symptoms like numbness or pain in the fingers or toes. Notify your healthcare provider if these symptoms arise as dosage adjustment or alternative treatment may be necessary.

• Growth Impact in Children: Methylphenidate ER may temporarily slow growth in children. Healthcare providers should monitor growth regularly and may adjust treatment if significant changes are observed.

• Serotonin Syndrome Risk: There's a risk of serotonin syndrome, particularly when combined with other medications affecting serotonin levels. Symptoms include fast heart rate, sweating, muscle stiffness, high fever, and confusion. Seek immediate medical help if these occur.

• Drug Interactions: Methylphenidate ER can interact with various medications, including those for blood pressure and certain antidepressants. Avoid concurrent use with monoamine oxidase inhibitors (MAOIs). Always discuss current medications with your healthcare provider before starting methylphenidate ER.

In cases of overdose, immediate medical attention is crucial. Always adhere strictly to prescribed dosages and consult your healthcare provider with any concerns regarding your treatment with methylphenidate ER.

When taking this medication, you might encounter some mild side effects such as nervousness, trouble sleeping, headache, loss of appetite, stomach pain, dizziness, nausea, and vomiting. These are typically not serious, but if they persist or worsen, it's advisable to consult with a healthcare provider for guidance and reassurance.

More significant side effects can occur, though they are less common. These include dry mouth, anxiety, irritability, and a racing heart. Additionally, sweating might be experienced. It is important to monitor these symptoms and seek advice from a healthcare professional if they become troublesome.

Rarely, more severe side effects may manifest, requiring immediate medical attention. These include signs of blood flow issues in the fingers or toes, uncontrolled muscle movements, sudden outbursts, and changes in vision. Mental and mood changes such as agitation, aggression, or abnormal thoughts should also be promptly addressed. Severe reactions, such as fainting, seizures, heart attack symptoms, or stroke indicators, necessitate urgent medical care.

In extremely rare cases, males, including young boys and teens, may experience a painful or prolonged erection lasting four or more hours. This situation requires immediate cessation of the medication and urgent medical intervention to prevent permanent damage.

Allergic reactions, though very rare, can occur, presenting as rash, itching, swelling, severe dizziness, or trouble breathing. Immediate medical help is crucial if these symptoms are observed. Always report new or worsening side effects to a healthcare provider for appropriate management.

When taking Methylphenidate ER, it's important to be aware of potential drug interactions. Avoid using this medication with monoamine oxidase inhibitors (MAOIs), such as isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, and Tranylcypromine, as this can lead to a serious, possibly fatal reaction. It's generally advised to stop MAOIs at least two weeks before starting Methylphenidate ER. Consult your doctor for guidance on when to safely start or stop this medication.

Additionally, alcohol should be avoided while taking Methylphenidate ER, as it can cause the medication to be released too quickly, increasing the risk of side effects. If you are using medications to reduce stomach acid, such as antacids, ranitidine, or Omeprazole, check with your pharmacist, as some brands of Methylphenidate ER may be affected by changes in stomach acidity.

Methylphenidate ER should not be taken with Dexmethylphenidate, as they are too similar. Also, inform laboratory personnel and your healthcare providers that you are using Methylphenidate ER, as it may interfere with certain medical tests, potentially leading to false results. Always discuss all medications and supplements you are taking with your doctor and pharmacist to ensure safe use.